52D2137712 CLIA NUMBER - MAHALA'S HOPE INC

Laboratory Demographics

  • CLIA Code: 52D2137712
  • Facility Name: MAHALA'S HOPE INC
  • Facility Address: N4590 HWY 45
    EDEN, WI
    ZIP 53019
  • Facility Phone: 920 904-6445
  • Facility Type: Other - CBRF FOR SUBSTANCE ABUSE
  • Facility Type: Waiver
  • Lab Director: MS. SANDRA J. HARDIE
  • NPI Number: 1073151874
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2137712
LAB Type Other - CBRF FOR SUBSTANCE ABUSE
Facility Name MAHALA'S HOPE INC
Street N4590 HWY 45
City EDEN
State WI
ZIP 53019
Phone 920 904-6445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2023
Certificate Expiration Date 10/2/2025
Facility Type Other - CBRF FOR SUBSTANCE ABUSE
Lab Director MS. SANDRA J. HARDIE

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This page was last updated on: 9/29/2025